Endoscopic surgical procedures typically involve techniques and instruments that require access to a surgical work site that is within a patient's body. Access is normally provided through one or more portals formed directly in the patient's body or through one or more cannulas inserted into the patient's body through small incisions. A chosen surgical procedure is carried out by a surgeon through the use of elongated instruments inserted through these cannulas to reach and conduct various surgical procedures at the work site.
Since the work site is only accessible through a small portal or cannula, it is very difficult to manipulate tissue or tie sutures within the body. Because only a small incision is made during endoscopic surgery, it is also often difficult to grab small regions of tissue and to simultaneously or subsequently apply a desired tension on the tissue, either in a direction toward or away from the arthroscopic portal. Further, manipulation of anatomical tissue at the work site during endoscopic surgeries frequently requires simultaneous use of additional instruments that are needed during various surgical steps such as cutting or removing tissue, or suturing or tying knots.
Accordingly, a need exists for an improved handle for surgical instruments that allows controlled tissue manipulation and retraction, as well as controlled manipulation of suture or other material elements that are employed during or in conjunction with endoscopic surgeries. A need also exists for surgical instruments (such as graspers, punches or scissors, among others) that are stable during arthroscopy and maintain the lifting/retracting orientation desired by the surgeon, without accidental slipping or shifting and with minimal soft tissue edema to the patient. Surgical instruments with a handle having an improved design that allows a surgeon to grip the handle ergonomically and to effectively maneuver tissue or adjacent structures are also needed. Instruments with a simplified actuating mechanism which facilitates use of the instruments during surgery are further needed.